The Medicalization of Society

UNM Center for Social Policy・2 minutes read

Frank Kessle welcomes attendees to a speaker series organized by Kristen Barker where Professor Peter Conrad discusses the medicalization of society, emphasizing varying levels across conditions and the dual aspects of benefits for individuals and drawbacks for society. Conrad's work delves into ADHD, PTSD, and the commercialization of medicine, highlighting resistance movements, the role of consumers, and predictions on the future of medicalization.

Insights

  • Medicalization, as discussed by Professor Peter Conrad, involves non-medical issues being treated as medical problems, with varying levels observed across different conditions, such as childbirth and schizophrenia being highly medicalized while internet addiction falls on the less medicalized end.
  • The costs of medicalization in the healthcare system were analyzed, revealing that 3.9% of total domestic healthcare spending in 2005 was attributed to 12 medicalized conditions, totaling $77 billion, highlighting both benefits for individuals with conditions and drawbacks for society.
  • Resistance to medicalization exists, with movements like the GLBT and Disability Rights Movements challenging medicalized conditions, emphasizing the importance of countervailing forces to counteract the surge of medicalization despite some pockets of resistance.

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Recent questions

  • What is medicalization?

    The process of non-medical issues treated medically.

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Summary

00:00

"Medicalization: A Complex Societal Phenomenon"

  • Frank Kessle, a senior fellow at the Health Policy Center, welcomes attendees to the speaker series organized by Kristen Barker and the Sociology department.
  • Professor Peter Conrad, a renowned figure in medical sociology, is introduced by Kristen Barker, highlighting his extensive contributions to the field.
  • Conrad's work focuses on the medicalization of society, transforming human conditions into treatable disorders, as discussed in his book published in 2007.
  • Conrad's personal journey into medical sociology began with his research on ADHD and the realization of the concept of medicalization.
  • Medicalization is defined as the process of non-medical issues being treated as medical problems, with examples like ADHD and hyperactivity.
  • Conrad emphasizes that medicalization is not inherently good or bad, but rather a phenomenon to be studied without moral judgment.
  • Medicalization has significantly expanded since the 1970s, with conditions like anorexia, obesity, PTSD, and sleep disorders becoming medicalized over time.
  • The key aspect of medicalization lies in the definition of a problem and its consequences, with varying degrees of medicalization observed in different conditions.
  • Childbirth and schizophrenia are examples of highly medicalized conditions, while internet addiction and shopping addiction fall on the less medicalized end of the spectrum.
  • Conrad encourages a nuanced understanding of medicalization, recognizing the complexity and varying levels of medicalization across different conditions.

15:43

Evolution of Medicalization and Societal Impact

  • Opiate addiction can lead to medical treatment or incarceration, with sociologists explaining the differences in outcomes.
  • Categories like PTSD and ADHD have expanded over time, with PTSD now including various traumatic experiences beyond war.
  • PTSD and ADHD definitions have evolved, with PTSD being useful for physicians despite debates on its validity.
  • ADHD has shifted from a childhood disorder to a lifelong condition, with a focus on attention over hyperactivity.
  • Medicalization involves the expansion and contraction of categories, such as the diagnosis of hysteria decreasing over time.
  • Doctor involvement in medicalization varies, with examples like pediatric bipolar disorder showing entrepreneurial tendencies.
  • Medicalization can also lead to demedicalization, as seen with the historical cases of masturbation and homosexuality.
  • The Gay Liberation movement successfully pushed for the removal of homosexuality as an illness from the DSM in 1973.
  • Factors driving medicalization include biotechnology, genetics, consumer influence, and the medicalization of conditions like obesity.
  • The future of medicalization may involve genetics and neuroscience, with consumers playing a significant role in shaping healthcare practices.

31:15

Costs and Consequences of Medicalization in Healthcare

  • The speaker collaborated with a graduate student and a health policy expert to analyze the costs of medicalization in the healthcare system.
  • They focused on direct costs of 12 medicalized conditions in 2005 using MEPS and other national data, finding a total of $77 billion spent.
  • This amount accounted for about 3.9% of total domestic healthcare spending, equivalent to public health and cancer expenditures.
  • The speaker highlighted the dual aspects of medicalization, discussing potential benefits for individuals with conditions and drawbacks for society.
  • They expressed concerns about the pathologization of human differences, turning everything into a medical disorder.
  • An allegorical story about the "last well person" illustrated the extensive diagnostic labeling in society.
  • The speaker discussed the medical profession's trend of defining normality, citing examples like the pharmaceutical industry's promotion of drugs for aging and sexual performance.
  • They delved into the pharmaceutical industry's influence on defining normal behavior, using Viagra's marketing evolution as a prime example.
  • The speaker raised concerns about the medicalization of shyness, detailing how drug companies created a disorder (social anxiety disorder) to promote a specific drug (Paxil).
  • Despite skepticism towards drug companies' practices, the speaker acknowledged the benefits some individuals derive from medications, sharing a personal anecdote about a family member's positive experience with SSRIs.

47:47

Medicalization and Consumer Influence in Healthcare

  • The speaker recalls a disruptive student in class who was sent to Catholic school despite not being Catholic, highlighting the strict discipline of nuns.
  • They express interest in biomedical enhancements, particularly genetic enhancements, predicting their future prevalence.
  • The speaker discusses the illegal promotion of human growth hormone by Genentech in 1985, primarily for individuals with growth hormone deficiency.
  • Human growth hormone treatment for short children was promoted, costing around $10,000 annually and resulting in an average height increase of two inches over five years.
  • The speaker delves into the concept of medicalization, focusing on the expansion of medical social control and the use of psychoactive medications in nursing homes and foster care.
  • They touch on medical excuses, ranging from school absences to avoiding military service or legal consequences, emphasizing their societal impact.
  • The clinical view is contrasted with a sociological perspective, highlighting how medicalized categories often overlook social influences on well-being.
  • The speaker discusses the increasing importance of consumers and medical markets in medicalization, citing examples like cosmetic surgery and biomedical enhancements.
  • They explore the commercialization of medicine, exemplified by the rise of bariatric medicine and the treatment of obesity as a disease.
  • The emergence of adult ADHD in the 1990s is attributed to consumer demand for medicalization, shifting the role of physicians from medical imperialism to gatekeepers in prescribing medications.

01:04:06

Patients as Consumers: Medicalization and Resistance

  • Medical experts and entrepreneurs now view patients as consumers.
  • Patients often possess more knowledge about their diseases than medical professionals.
  • Resistance to medicalization exists, with Don Light introducing the concept of countervailing forces.
  • Medicalization lacks counteracting forces, leading to a surge of medicalization despite pockets of resistance.
  • Various movements, such as the GLBT and Disability Rights Movements, challenge medicalized conditions.
  • Disagreements exist within movements, like transgender individuals questioning the inclusion of certain conditions in the DSM.
  • Resistance to medicalization extends to areas like childbirth, ADHD, obesity, and aging.
  • The commercialization of anti-aging products and pharmaceuticals is on the rise.
  • The globalization of ADHD is a current focus for further research.
  • Cross-cultural aspects of medicalization remain understudied, with examples like menopause showing differing perceptions across cultures.

01:20:10

Global Rise in ADHD Diagnosis and Medicalization

  • Rates of ADHD diagnosis have increased globally, not just in North America and Australia.
  • The speaker avoids delving into the reasons behind this rise, focusing on criminology instead.
  • The book "Deviant Medicalization" explores the historical medicalization of various issues until 1980.
  • Alcoholism and crime were once viewed as brain diseases but have since been debunked.
  • Schizophrenia remains heavily medicalized, with many individuals with the condition ending up in prisons.
  • An article by "Adam L's mother" highlights the struggle to access mental health treatment outside of prison.
  • The speaker shares the article with psychiatrist friends who agree with its points.
  • The speaker discusses the lack of counterbalancing powers against medicalization in society.
  • The use of psychotropic medications among active-duty military personnel is highlighted, potentially contributing to mental health issues.
  • The speaker predicts the emergence of memory-enhancing drugs, foreseeing both therapeutic and enhancement uses.

01:37:00

"Evolution, Social Movements, and Medical Education"

  • The speaker discusses the potential benefits of new treatments and the idea that evolution may be more intelligent than drug companies.
  • Reference is made to historical events like the anti-war movement in the 1970s, highlighting a shift in questioning authority and defiance towards medicalization.
  • Various social movements, such as the resistance disability movement and the fat acceptance movement, are mentioned for their role in questioning authority and medicalization.
  • The importance of including social determinants of health in medical training, particularly for future doctors, is emphasized, with a focus on the MCAT's requirement for students to learn about these aspects.
  • The speaker expresses support for the inclusion of social sciences in medical education, noting the significance of sociology and behavioral sciences in healthcare and the potential for sociology to attract science-oriented students.
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